CEEOL - Search Result

Response to Ruud ter Meulen

Author(s): Ruth Chadwick / Language(s): English / Issue: 43/2015

Keywords: solidarity; community; institutions; transformation; equity

In addition to thinking about the meanings of solidarity, it is important to address how solidarity of the appropriate sort can be cultivated. Possibilities include the transformative power of key individuals or events; and the role of institutions. In health care it is suggested that a combination of the two strategies is required. Professional conduct includes not only acting in 'face to face' delivery, but also engaging with those institutions which enable or disable certain ways of acting, so that they are constantly subject to revision to ensure that they facilitate the provision of decent healthcare.

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Rescuing Solidarity from Its Carers. A Response to Professor ter Meulen

Author(s): Giovanni De Grandis / Language(s): English / Issue: 43/2015

Keywords: solidarity; justice; community; individuality; healthcare ethics; ethics in practice; field philosophy; normative and descriptive ethics

The paper points out three serious problems in Ruud ter Meulen’s view of solidarity and of its role in healthcare ethics. First, it is not clear whether and to what extent ter Meulen expects normative concepts to be rooted in existing social practices: his criticism of liberal theories of justice seems to imply a different view on this issue than his implicit assumption that normative concepts are independent from social and historical trends. Second, it is not clear at which level his notion of solidarity is meant to be applied: does it provide principles for individuals or for institutions? Nor is it clear at what level of generality it should work: is it meant for healthcare institutions or for states, for citizens or for healthcare practitioners? Third, it is not at all clear how the communitarian and the universalist aspirations in his conception of solidarity can be reconciled.In light of such difficulties it is argued that within philosophical discourse solidarity can be a useful notion only if it can be clearly distinguished from existing and commonly used ethical concepts. Three examples of such narrow and specific uses of solidarity are presented. Finally, a sceptical view of confining the work of applied philosophers to articulating normative concepts is put forward and an alternative view of blending empirical and philosophical analysis is proposed. This vision of field philosophy requires serious attention and careful understanding of the circumstances and constraints within which normative recommendations operate. It is suggested that such a modest and empirically grounded understanding of normative work is a better way of honouring the belief that philosophy is rooted in social institutions and in complex webs of relations.

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Just Solidarity: The Key to Fair Health Care Rationing

Author(s): Leonard M. Fleck / Language(s): English / Issue: 43/2015

Keywords: solidarity; humanitarian solidarity; health care rationing; justice; rational democratic deliberation; just caring; public reason; veil of ignorance

I agree with Professor ter Meulen that there is no need to make a forced choice between “justice” and “solidarity” when it comes to determining what should count as fair access to needed health care. But he also asserts that solidarity is more fundamental than justice. That claim needs critical assessment. Ter Meulen recognizes that the concept of solidarity has been criticized for being excessively vague. He addresses this criticism by introducing the more precise notion of “humanitarian solidarity.” However, I argue that these notions are still not precise enough and are in need of behavioral translation, especially in relation to the problem of fair health care rationing. More specifically, I argue that translation ought to take the form of a well-ordered process of rational democratic deliberation, which I describe and defend in this essay. Such a process is what is required to construct a working model of just solidarity as opposed to a merely abstract idealization of just solidarity.

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Solidarity: A Local, Partial and Reflective Emotion

Author(s): David Heyd / Language(s): English / Issue: 43/2015

Keywords: solidarity; justice; sympathy; bioethics; ter Meulen

Solidarity is analysed in contradistinction from two adjacent concepts - justice and sympathy. It is argued that unlike the other two, it is essentially local (rather than universal), partial (rather than impartial) and reflective (an emotion mediated by belief and ideology, interest and common cause). Although not to be confused with justice, solidarity is presented as underlying any contract-based system of justice, since it defines the contours of the group within which the contract is taking place. Finally, due to the fact that health is a typically universal value and being a primary good it is something which should be distributed justly, solidarity seems not to have any central role in bioethics.

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Funding Genetic Tests from Public Resources

Finansowanie testów genetycznych ze źródeł publicznych

Author(s): Olga Dryla / Language(s): Polish / Issue: 44/2015

Keywords: genetics genetic tests; diagnostic tests; preventive tests; screening tests; refund for tests; D. C. Wertz; J. C. Fletcher; K. Berg; Muin J. Khoury; C. G. van El; M. C. Cornel

One of the signs of the rapid development of medical genetics is a gradual increase in the number of genetic tests available. Different aspects of this phenomenon have been addressed and debated in the source literature, but so far relatively little has been said about the obligation to provide equal access – in the social context – to selected kinds of tests. In this article, I attempt to reconstruct those few suggestions, dealing with the principles of funding genetic tests from public resources, that can still be found in the source literature. Accordingly, I have analyzed the possibilities of identifying the criteria of selecting diagnostic and preventive tests (in the slightly modified sense attributed to these categories) to be eligible for refund, as well as of screening programmes.

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The Benefits of ART, or a Problem of Families and Children? Comments on the Proposed Amendments to the Law on Infertility Treatment – Sejm’s draft no 3245 (in Polish)

Dobrodziejstwo nowoczesnych technik wspomaganej medycznej prokreacji czy problem rodziny i dziecka? Uwagi na tle projektu ustawy o leczeniu niepłodności (druk sejmowy 3245)

Author(s): Jadwiga Łuczak-Wawrzyniak,Joanna Haberko / Language(s): Polish / Issue: 44/2015

Keywords: infertility; medically assisted procreation; sperm donation; oocytes; children’s welfare; the right to know one’s genetic origin; Anna Grabinski; Tadeusz Smyczyński; Tadeusz Jasudowicz

The use of assisted reproductive technology (ART) is becoming more and more common nowadays and the procedures that a few years ago would be seen as experimental have now become basic benefits. The present text covers the issues of risks and conflicts faced by family members and related with the use of technology in the process of conceiving and giving birth to a child. The authors pay special attention to the possible use of foreign germ cells in the conception of a child. The article aims to demonstrate that the use of modern and advanced medical technology in health care in the field of medically assisted procreation may be seen as a benefit for the family, which satisfies the desire to have a child, but in the long run it may give rise to legal or psychological problems as well. The authors examine the draft on the infertility treatment

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The Role of a Technological Approach in the Contemporary Psychiatry

O roli myślenia technologicznego w psychiatrii współczesnej

Author(s): Andrzej Kapusta / Language(s): Polish / Issue: 44/2015

Keywords: philosophy of psychiatry; technology; technological reason; diagnosis; psychiatric expertise; Martin Heidegger; James Phillips; John Sadler; Jeniffer Radden

The emergence of new technologies has had a significant impact on the development of modern psychiatry. Brain scanning, biochemical analysis, the search for genetic markers, and the development of psychopharmacology have had a great influence on the way we understand the nature of mental disorders and the role and place of mental health specialists. The article aims at presenting the consequences of a technical approach in psychiatry, giving examples of such an approach and proposing a critical attitude to this approach and the role of technical expertise in psychiatry.

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Reducing Organ Shortage. Active Donor Registration System as an Alternative to the Polish Opt-Out System

Ograniczanie niedoboru narządów. System Aktywnej Rejestracji Dawców jako alternatywa dla polskiej regulacji sprzeciwu

Author(s): Piotr Grzegorz Nowak / Language(s): Polish / Issue: 44/2015

Keywords: Active Donor Registration system; opt-out; presumed consent; organ shortage; Govert den Hartogh

In the article I argue for replacing the opt-out system of organ donation, currently applied in Poland, with the Active Donor Registration system (ADR). The basic idea of the ADR system is to send a special form to all adult citizens, which would give them an opportunity to consent or dissent to the removal of organs, or to delegate their decision to their next of kin. Granting priority to declared donors – an additional assumption of ADR – would make it possible for them to acquire better access to transplantation if they ever contract a disease whose effective treatment will require transplantation. I highlight the basic assumptions of both systems and describe the functioning of the Polish opt-out regulations. I also analyze the statistical data illustrating the scale of organ shortage in Poland, and I present and criticize the basic ethical principles of evaluating organ procurement systems and compare the Polish system with the ADR system from the perspective of those principles.

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What Kind of Justice Can We Expect from a Medical Doctor?

Jakiej sprawiedliwości wolno oczekiwać od lekarza?

Author(s): Marek Olejniczak / Language(s): Polish / Issue: 44/2015

Keywords: justice; social justice; virtue; doctor; public healthcare system; medicine; ethics; J.F. Drane; E.D. Pellegrino; N. Daniels; M. Kolwitz;; K. Szewczyk

The essential objective of the paper is to demonstrate the complexity of issues related to justice in the medical profession. The author claims that the virtue of justice as the foundation of a good doctor's moral attitude and the concept of justice in allocating medical goods are of primary importance. The most important thesis presented in the paper is that even if the so-called social justice needs to be complied with in the public healthcare system, it has nothing to do with the virtue of justice applicable to the medical profession. The idea of social justice (not equally clear to everyone) is the foundation of the public healthcare system. However, burdening doctors with the necessity to make decisions about rationing access to medical services increases neither their job satisfaction, nor the well-being of patients. Thus, joint efforts of doctors, economists, ethicists and politicians are required in this area.

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Informed Consent and Research Involving Human Biological Material

Dyskusja wokół koncepcji świadomej zgody w kontekście badań naukowych z użyciem ludzkiego materiału biologicznego

Author(s): Jakub Pawlikowski / Language(s): Polish / Issue: 44/2015

Keywords: research ethics; informed consent ; blanket consent; broad consent; biobanks; human biological material

The development of research based on human biological material has contributed to a lively debate on the concept of informed consent in these studies, particularly its scope, form and length of validity. The biggest disputes and doubts concern the range of consent for research that will be conducted in the future, whose aim and place are unknown at the time of the sample collection, as are the future researchers and the ability to use the previously collected materials again. This situation raises the question of a just and prudent balance between the rights of participants in the research and the rights of researchers. New forms of consent have been proposed, which sometimes substantially diverge from the classical model (e.g. blanket consent or broad consent and its various kinds) in aiming towards responsible balancing between the necessity to protect the donors’ interests and the possibility of conducting research in medicine. These new concepts also find their application in legislative acts adopted internationally and in some European countries in the recent years.

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Hume, Justice and Sympathy: A Reversal of the Natural Order?

Author(s): Sophie Botros / Language(s): English / Issue: 44/2015

Keywords: justice; sympathy; virtue; sentimentalism; passion; motive; character; self-interest; impartiality; consequences

Hume’s view that the object of moral feeling is a natural passion, motivating action, causes problems for justice. There is apparently no appropriate natural motive, whilst, if there were, its “partiality” would unfit it to ground the requisite impartial approval. We offer a critique of such solutions as that the missing non-moral motive is enlightened self-interest (Baier), or that it is feigned (Haakonssen), or that it consists in a just disposition (Gauthier). We reject Cohon’s postulation of a moral motive for just acts, and also Harris’s attempt to dispense with motive as the source of their merit, by invoking extensive sympathy, and citing their beneficial societal consequences. These solutions assume that, if Hume remains a virtue ethicist, the natural virtues supply the paradigm. Taylor claims that a revolution in motivational psychology follows the inauguration of the artificial convention of justice, remoulding the natural virtues. This solution founders, we argue, upon unresolved contradictions besetting even these virtues.

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Why Compassion Still Needs Hume Today

Author(s): Margreet van der Cingel / Language(s): English / Issue: 44/2015

Keywords: compassion; love; imagination; sympathy; pity; suffering; grief; emotion; empirical research; healthcare

Over the past years the relevance of compassion for society and specific practices such as in healthcare is becoming a focus of attention. Philosophers and scientists discuss theoretical descriptions and defining characteristics of the phenomenon and its benefits and pitfalls. However, there are hardly any empirical studies which substantiate these writings in specific societal areas. Besides, compassion may be in the eye of attention today but has always been of interest for many contemporary philosophers as well as philosophers in the past, David Hume amongst them. Three themes related to Hume’s hypotheses on compassion are discussed and compared to outcomes of an empirical study amongst nurses and patients with a chronic disease. This comparison gives insights into the perception of those for whom compassion is of specific importance in their daily lives and into the usefulness of Hume’s notions on compassion.

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David Hume: Unwitting Cosmopolitan?

Author(s): Edward W. Glowienka / Language(s): English / Issue: 44/2015

Keywords: Hume; cosmopolitanism; patriotism; commerce; custom; sympathy

If Hume is considered cosmopolitan in his ethics at all, he is said to be so through his anti-mercantilist approach to commerce. Prevailing commercial interpretations attribute to Hume a cosmopolitanism that is best described as instrumental and supervenient. I argue that Hume’s principles lead to a cosmopolitan ethic that is more demanding than commercial interpretations recognize. Hume’s cosmopolitanism is more than merely supervenient and its instrumentality is such that cosmopolitan regard becomes inseparable from healthy patriotic concern. I show sympathy and duty, not merely justice, central to Hume’s cosmopolitanism and address how Hume’s moderate cosmopolitanism might be enacted in society. I suggest Hume’s view can contribute to contemporary cosmopolitan discourse, aiding both those forms with which it is consonant and the practical ends of otherwise opposed, Kantian forms.

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Justice, Sympathy and the Command of our Esteem

Author(s): Jacqueline Taylor / Language(s): English / Issue: 44/2015

Keywords: regard for justice; common sense of interest sympathy; humanity; esteem

I have shown here the different roles that sympathy plays in the accounts of justice in the Treatise and Enquiry. In the former work, a redirected sympathy naturally extends our concern, and subsequently our moral approval or blame, to all those included within the scope of the rules of justice. In the Enquiry, we find this same progress of sentiments, but Hume’s introduction of the sentiment of humanity allows him to make a stronger case for the importance of those virtues that are useful, particularly the virtues of justice. The command of our esteem and our moral approval of justice secure a place for justice at the heart of Hume’s ethics. This does not entail, however, that other useful virtues are not also essential. Benevolence and the care of children, friendship, and gratitude not only help to sustain sociability, but they are essential for living a properly human life.

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Hume's Humanity and the Protection of the Vulnerable

Author(s): Ivana Zagorac / Language(s): English / Issue: 44/2015

Keywords: David Hume; humanity; justice; vulnerability; protection of the vulnerable

It is well known that Hume excluded inferior rational beings, who are incapable of resistance and weak resentment, from his concept of justice. This resulted in a critique of Hume’s theory of justice, as it would not protect those who were the most vulnerable against ill treatment. The typical answer to this critique is that Hume excluded inferior rational beings from the concept of justice, but not from that of morality, and that he considered their protection to be the task of humanity. The subject of this text is the range of Hume’s humanity. What manner of protection does Hume’s humanity truly offer? Despite the conclusion that this manner of protection of the vulnerable is insufficient, Hume’s humanity contains valuable characteristics worthy of re-evaluation in modern debate — both on the limits of humanity and on the conditions and models of protecting the vulnerable.

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Solidarity in the legal frames

Author(s): Aleksandra Głos / Language(s): English / Issue: 44/2015

Keywords: solidarity; health care; responsibility; welfare state; legal framing; decent care; R. Ter Meulen; A. Margalit; H. Frankfurt

The purpose of this paper is to explore the meaning of solidarity and its proper position in the legal frames, with particular focus on health care. Solidarity is often identified with welfare arrangements and social guarantees. In this institutional version, it tends to humiliate citizens and restrict their entrepreneurship. Moreover, administrative solidarity is unable to recognize the actual needs of the most vulnerable members of society, which should be one of its primary concerns. Solidarity, in its original meaning, understood as supportive cooperation of fellow citizens, links their rights and freedoms with mutual duties and responsibilities. Hence, an alternative framework for solidarity should be provided. This framework, committed to the idea of decency, introduces the distinction between the minimum and maximum content of solidarity enforceable by legal means, which should be translated into certain health care practices.

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Thinking About End of Life in Teleological Terms

Author(s): Paolo Biondi,Rachel Haliburton / Language(s): English / Issue: 45/2015

Keywords: bioethics; Aristotelian; fundamentalist; end of life; telos; eudaimonia; death; illness; suffering ; virtue

This brief paper presents an Aristotelian-inspired approach to end-of-life decision making. The account focuses on the importance of teleology, in particular, the telos of eudaimonia understood as the goal of human flourishing as well as the telos of medicine when a person’s eudaimonia is threatened by serious illness and death. We argue that an Aristotelian bioethics offers a better alternative to a “fundamentalist bioethics” since the telos of eudaimonia (i) offers a more realistic conception of the self and the realities of frailty and mortality, (ii) provides a more objective basis for making decisions regarding end-of-life treatment and care, and (iii) is better able to resist the pull of the Technological Imperative. In addition, this teleological concept is flexible enough for it to be employed in multicultural and pluralistic societies.

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Changing Kinds: Aristotle and the Aristotelians

Author(s): Stephen R. L. Clark / Language(s): English / Issue: 45/2015

Keywords: species essentialism; Aristotle teleology; genetic engineering; evolutionary theory

Aristotle is routinely blamed for several errors that, it is supposed, held 'science' back for centuries - among others, a belief in distinct, homogenous and unchanging species of living creatures, an essentialist account of human nature, and a suggestion that 'slavery' was a natural institution. This paper briefly examines Aristotle's own arguments and opinions, and the perils posed by a contrary belief in changeable species. Contrary to received opinion even amongst some of his followers, Aristotle was not a species essentialist and his ethical theory, properly expanded, provides arguments against bioengineering human and other species without a clear view of what should count as beauty.

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Wittgenstein 1929-1930 – the Problem of Colour Exclusion

Wittgenstein 1929–1930 – problem dwóch kolorów w tym samym miejscu

Author(s): Szymon S. Nowak / Language(s): Polish / Issue: 46/2015

Keywords: Wittgenstein; phenomenology;grammar; colour; logical atomism;

The colour incompatibility claim was first introduced by Wittgenstein in the Tractaus. It states that there can be only one colour in one place and time. It is commonly believed that Wittgenstein abandoned his conception of logical atomism after he had understood the consequences of his colour incompatibility claim.The main goal of this article is to provide an interpretation of the colour incompatibility claim in terms of Wittgenstein's phenomenology. I will focus on two works which are of great significance for the colour incompatibility claim, namely, Some Remarks on Logical Form and Philosophical Remarks. The period between 1929 and 1930 is the time when these two works came into existence, and it is the beginning of the “middle period” of Wittgenstein's philosophy. My attention will not only concern the fact that Wittgenstein formulated the colour incompatibility claim, but I will also address the issue of how this claim was justified. The grasp of Wittgenstein's justification of the colour incompatibility claim will help to understand his phenomenology and his theory of philosophical grammar.

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Searle and Putnam on the Nature of Mental States

Searle, Putnam i natura stanów mentalnych

Author(s): Przemysław Paleczny / Language(s): Polish / Issue: 46/2015

Keywords: Searle; Putnam; mental states; internalism; externalism; Cartesian Theater; perception; intentionality

The paper deals with the controversy between internalism and externalism on the nature of mental states, and its relevance to the philosophy of perception. In particular, the controversy between Hilary Putnam's natural realism and John Searle's direct realism is discussed. It is argued that Searle's defense of internalism fails to meet Putnam’s objections. Putnam’s case is even strengthened and the very source of the internalism vs. externalism controversy is identified in their shared assumptions. The rejection of these assumptions, together with the underlying myth of Cartesian Theater, makes the controversy meaningless. Finally, the relations of Searle’s and Putnam’s views to the Cartesian framework in the philosophy of perception are discussed.

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